A U.S. attorney just blew the lid off an intricate fraud scheme allegedly orchestrated by a former QVC director.

The ex-executive, 42-year-old James D. “Jamie” Falkowski, was charged with multiple accounts of fraud for stealing over $1 million worth of money, goods and services from the popular West Chester-based TV shopping network. And no, he didn’t use the funds to cover some aging relative’s medical bills. Instead, he dropped thousands on extravagant spa treatments, Botox appointments, first-class travel to destinations like Turks and Caicos, plus all the lavish meals and hotel stays that accompanied his faux swanky agenda.

QVC fired Falkowski in December 2013 after he had worked with the company for six years. During his stint, he also allegedly duped the company out of about $200,000 in private luxury rides for himself and friends and about $70,000 in payments to his personal vendors and creditors. That even included more than $28,000 in payments to a custom furniture maker commissioned to design two tables for his Philly pad and about $60,000 in pre-paid American Express, Tom Ford, and Barney’s New York gift cards that he used for himself. He gave at least tens of thousands of dollars’ worth of QVC products to his friends and associates by abusing the company’s product requisition process, prosecutors said in a statement. Read more »

A Delaware County podiatrist was charged in the largest health care fraud takedown in history, the Department of Justice announced today.

Stephen A. Monaco, of Broommall, Pa., is charged in a $5 million scheme to defraud Medicare, Medicaid and four private victim insurance companies. The charging information alleges that Monaco committed fraud through his Havertown office, A Foot Above Podiatry.

The Department of Justice announced Monaco’s charges as part of the largest sweep led by the Medicare Fraud Strike Force in history, resulting in criminal and civil charges against 301 people, including 61 doctors, nurses and other medical professionals who participated in health care fraud schemes. The sweep involved about $900 million in false billings.

In November of 2013, Melanie Bullock was assaulted and stabbed in Philadelphia. She survived the incident, and reached out to the state’s Victim Compensation Assistance Program for help a few months later. Her story took a bizarre turn from there.

The fund provides financial assistance to crime victims, so Bullock fit the bill. The problem, according to the state Attorney General’s Office, was that Bullock allegedly provided the program with phony pay stubs and tax records in an attempt to collect $38,500 in supposedly lost wages.

Investigators from the A.G.’s Office dug into the lost earnings claim Bullock filed in May of 2014, which indicated that she was a finance manager at a company called Blue Ivory Stones LLC, supposedly earning $5,500 a month. Bullock even had her boss, Tara Johnson, sign off on some forms, confirming the whole story.

When it comes to Medicare and Medicaid fraud, the government isn’t just going after doctors and hospitals — it’s going after patients as well.

Just take the case of dialysis patient Keisha Regusters, 38, of Philadelphia. She pleaded guilty today to a fraud scheme where she allowed Brotherly Love Ambulance Inc. to drive her to dialysis treatments even though she could walk and get there by other means. She took the rides and Brotherly Love charged Medicare — then provided Regusters monthly kickbacks, the the U.S. Attorney’s Office said.

The executive director of a North Philly nonprofit is accused of swindling the organization out of $85,000, and making ATM withdraws from the corporate bank account at local casinos.

Rodnell Griffin, 67, allegedly siphoned the money from Hunting Park Neighborhood Advisory Committee between January 2007 and October 2013. On 10 occasions, Griffin made ATM withdrawals at Parx, SugarHouse Casino and ATMs just outside of those locations, the indictment claims. Those amounts ranged from $203 to $404. In fact, the indictment says she amassed $5,300 in bank fees and charges during that six-and-a-half year period. (See the full indictment below.) Read more »

Because Philadelphia has such a large aging population, carriers attempt to overcharge Medicare for repeated, perhaps unnecessary ambulance trips. (Some carriers even go so far as to, for example, pay seniors to take an ambulance to the hospital for dialysis instead of walking.) Since February, new ambulance operators in the Philadelphia area have been barred from becoming eligible to receive Medicare payments. This prevents blacklisted carriers from shutting down and reorganizing instantly.